Long term follow-up for bimanual microincision cataract surgery (B-MICS) performed by surgeons in training

Session Details

Session Title: Cataract Surgery Outcomes and Practice Styles

Session Date/Time: Wednesday 09/09/2015 | 08:00-09:30

Paper Time: 08:24

Venue: Room 17

First Author: : M.Forlini ITALY

Co Author(s): :    T. Verdina   V. Volante   R. Peschiera   L. Chiesi   G. Delvecchio   G. Cavallini     

Abstract Details

Purpose:

To determine the efficacy of B-MICS performed by surgeons in training in a 18 months follow up and to evaluate posterior capsule opacification (PCO) incidence and microincision's characteristics comparing the results with those obtained by an experienced surgeon.

Setting:

Institute of Ophthalmology, University of Modena & Reggio Emilia, Modena, Italy (Head: Prof. Gian Maria Cavallini).

Methods:

60 eyes of 51 patients operated by three surgeons in training that used B-MICS technique for the first time and with a 18 months follow-up were included in the study. 60 eyes of 49 patients who underwent B-MICS by an experienced surgeon at 18 months follow-up were included as comparison for PCO and microincisions evaluation. Best corrected visual acuity (BCVA), astigmatism, corneal pachymetry and endothelial cell count were evaluated before and after surgery in the training group. AS-OCT was performed to study corneal incisions. PCO incidence was evaluated with EPCO 2000 software.

Results:

In the training group, at 18 months, mean BCVA improvement was 0.48±0.22 (p=0.003). We found no statistically significant induced astigmatism (p=0.068) neither corneal pachymetry changes (p=0.084). We noticed a statistically significant endothelial cell loss (mean loss 486.34±502.72 cells/mm2, p=0.004). In the training group EPCO score was 0.163±0.196 while for the expert surgeon 0.057±0.132 (p=0.002). Mean microincisions' length and inclination for surgeons-in-training and for the expert surgeons were respectively 1358±175 and 1437±256um and 141.8±6.4 and 148.7±5.1°. In the training group 12 cases of endothelial gap (10%) and 14 cases of posterior wound retractions (11.6%) have been detected.

Conclusions:

B-MICS is an effective technique even when performed by surgeons in training. PCO incidence seems to be higher in surgeons in training. Microincisions in the training group present lower values in terms of length and inclination in comparison with those considered for the expert surgeon.

Financial Interest:

NONE